It is something that everyone as a child must have faced; the fear of needles and the fear of injections. While you can surely bribe a child with some candy for flu shots, it might be difficult to drive home the point that insulin injections are a permanent reality in diabetes type 1. Let alone kids, many adolescents and adults are not in the least comfortable with daily insulin therapy.
As most people might find opting for an insulin pump an expensive alternative, it is imperative that this issue, of needle phobia, be addressed and put to rest once and for all in order to get along with diabetes treatment.
What is the fear of needles and fear of insulin?
Call it Trypanophobia (fear of any medical procedure) or Aichmophobia (fear of needles); it is but a natural response for someone to be afraid of a painful sensation. In the case of medical procedures, their invasive nature is an obvious reason to be anxious about. However, if this anxiety is exaggerated, it turns into a phobia.
There are a lot of psychological aspects to a fear of any medical procedure or even medicine. In the case of children, since they are not used to be pricked, it is a natural response. However, there are strategies that help toddlers and children overcome this fear.
In the case of adults, anxiety, an unfavorable past experience and mistrust might lead to phobias of medical procedures and medicines. This needs to be addressed immediately by the care team and family members as it can affect compliance to insulin therapy. This can easily snowball into negative outcomes in their diabetes control and can even lead to serious diabetes complications.
Fear of insulin therapy
As we know, the fear of insulin for a child is more of a natural response to pain. This can be managed with proper initiation, training, and rewards. However, the fear of insulin therapy is a little more complex in adolescents and adults.
Insulin therapy – Challenges in adolescents
Well, it is a reality that dealing with a teenager can drive parents to their wits’ end. It becomes that much more difficult in order to deal with an adolescent who has type 1 diabetes as they just don’t seem to understand the gravity of the situation. It is more of reluctance, negligence, and the turmoil of change rather than fear.
It would certainly be very embarrassing and depressing for an adolescent to inject insulin in the presence of their peers!
Evidently, it is seen in many studies that outcomes of type 1 diabetes treatment in adolescents are not the best. This is certainly a cause for concern as lack of adherence to treatment means increased HbA1c and an increased risk of diabetes complications.
This most likely is attributed to:
- Developmental changes that occur in adolescence
- Reduced parental influence as a result of age
- Peer pressure
- Psychological changes
- Pubertal behaviors
- Eating disorders associated with this age group
Insulin therapy – Challenges in adults
Adults with type 1 diabetes have a different set of challenges that lead to poor adherence in insulin therapy. By this time, they are already used to face different situations with their insulin therapy. Most of them would have gotten accustomed to issues like:
- Errors in the way they administer insulin with their insulin pen
- Improper storage of diabetes supplies including insulin pens, vials, & unused cartridges
- Dosing errors
- Injection site overuse
- Even, faulty injection technique
With progressing age, challenges and pressures of personal life tend to influence diabetes control and treatment adherence in many. For example:
- Family & impact of relationships
- Concerns of conceiving & having children
- Fear of other complications
With so much going on, the chances of missing out on self-monitoring with glucometers, and missing out on a dose increase. This leads to increased risk of low sugar levels and hypoglycemia or hyperglycemia. With poor long term control, HbA1c levels tend to rise increasing the risk of diabetes complications and cardiovascular diseases.
Overcoming fear, self-neglect, and other challenges in insulin therapy
It is obvious that there is no “one-size-fits-all” solution. In many cases, there is a need for the intervention of endocrinologists, dieticians, diabetes educators, and communities. This is because type 1 diabetes is something that needs continuous monitoring.
Since a diabetes doctor cannot be with the patient all the while, there is need for active participation of the family, diabetes educators, and dieticians. The usage of technology in order to address the challenges of managing type 1 diabetes is also on the rise.
Overcoming insulin injection fear: Strategies for toddlers & children
- Preparing the child before injection: Talking to a child, holding them, and reassuring them helps
- Distracting them with a game or song can help the child cope with pain of insulin injection
- In case of children, deep breathing works in reducing pain
- Gamifying the process of taking insulin on a daily basis also helps
- After injecting, praise them for being brave and for doing their best to overcome their fear of insulin injections
- For those who throw tantrums, it is better to address this professionally as this can turn into a lifelong fear. Talk to your endocrinologist about behavioral therapies
Overcoming insulin therapy challenges in adolescents & adults
It is not common for an adolescent or an adult to have a fear of insulin injections. In case they have had experiences with wrong dosage or any other issue, they might be anxious every time they inject insulin. The best course of action for this is to consult an endocrinologist or a diabetes educator in order to understand the dos and don’ts of insulin injection and the proper techniques to inject.
For this, a team approach to manage diabetes is very important. Having someone to reach out to when in case of doubt is reassuring and can help a person overcome anxiety with insulin therapy.
The use of technology like smartphone glucometers can be of great help as they can pass on the current blood sugar levels to the care team who would then provide actionable advice.
Adolescents who suffer from poor adherence would benefit by involving in communities for type 1 diabetes. Being in the company of people with the same condition would help them overcome many stigmas associated with type 1 diabetes. If you have any specific concerns regarding insulin therapy, please drop your queries in the comments section